Thursday, April 27, 2017

My Story of Secondary Infertility: Part 3

As a way to observe National Infertility Week, I have decided to share our story of infertility in hopes it may help at least one person. This story is extremely personal to me and has taken tremendous effort to live through and now write about. I understand firsthand how taboo the topic of infertility can be. Please keep in mind how vulnerable I am making myself when reading and commenting.

I shared the first part of our story, the birth of our daughter, here. She was conceived naturally without any issues. The next step was trying to get a diagnosis and I shared that here. Then we began treatments to help us get pregnant. I will go into the first part of that today.

After we had as many diagnostic tests run as were indicated at the time, we called Advanced Fertility for a consultation appointment. It was bittersweet. I was hopeful that they would be able to help us, but kind of in shock we were at this point since we had conceived our daughter so easily. This was almost 2 years after we initially started trying to have another child. In meeting with the doctor, she believed the next step to be an IUI and we could do that with my next cycle.
The fertility clinic always does an ultrasound as a part of the consultation and saw what they thought to be a polyp. So that meant going back to my OB and getting an HSG with contrast to check the uterine lining. It also meant another month delay. Everything was completely fine on the HSG so by late May of 2016 we were able to do our first IUI.

If you are unfamiliar with an IUI, what happens is the woman is put on medication to ensure ovulation (Clomid or Femara). Then she is typically monitored and given a shot to trigger ovulation. The IUI procedure is timed to coincide with ovulation, typically 36 hours after the trigger shot. The man is asked to give a 'specimen' which is then washed and some or most of the poor quality sperm is taken out with good quality sperm left. Then a catheter is inserted into the uterus and the sperm are inserted through the catheter directly into the uterus hopefully increasing the amount of good quality sperm that reach the uterus and the egg for fertilization. IUIs are around 15% successful which is actually less than a couple without fertility issues (they have around a 20% each month of becoming pregnant). IUI cycles that are monitored typically cost around $1200 with another $125 for the HCG medication used for a trigger shot.
I had to go on Clomid again for this and the migraines were back. I had to do my first subcutaneous injection, too. That means a stomach shot called a trigger to trigger ovulation make the body ovulate at a certain time. That way they can time the IUI correctly for maximum success. We found out in June it didn't work.

We had to take a month off before trying another IUI because of a summer vacation we had planned. I also talked to the doctor about how Clomid was affecting me and she recommended putting me on a different drug, Femara, instead. She said there were less side effects and a decreased chance for multiples and hopefully that would help my migraines. Once back from our vacation in July, I was placed on the lowest dose of Femara and started monitoring appointments around day 10 of my cycle. Each monitoring appointment consists of a blood draw and ultrasound to check the follicles on your ovaries for their size. This helps them time the trigger shot so the follicles and eggs inside are mature and ready for ovulation. This time it took a while because Femara wasn't as effective so I had extra monitoring appointments because my follicles weren't growing as fast. These appointments are typically every other day until they tell you when to give yourself the trigger shot. Once again, we found out it didn't work.

Based on what I had read online and in studies, the chance of success with an IUI drops dramatically after 3 tries. So my husband and I discussed doing our last IUI in August and then if that didn't work we decided to go ahead with IVF. It's a big decision to do that. The time commitment it huge because there are more monitoring appointments and just the time it takes to make appointments, do all the shots, order more medication, recover from egg retrieval surgery, and more, not to mention the financial aspect of it. But we knew how much we wanted another child so we made a commitment to ourselves. This time I was on a larger dose of Femara and it worked well. We had our procedure in late August. This time things felt a little different. When I tested in early September, I had a very faint positive. The clinic told me to try again the next day and see if it got darker. It didn't. The next morning was a negative. I ended up starting a new cycle 3 days later. They said I had a chemical pregnancy. When the fertilized egg never fully implants into the womb. It's a miscarriage that happens very early on, often times before the woman even knows she is pregnant. Knowing this now, I realized I had a chemical pregnancy earlier that spring as well when I thought I had a false positive and was a few days late. Being so close and having it not work yet again, and then knowing the next step was IVF really took its toll on us. I tried to take heart in knowing that IVF is the end of the road treatments. There is nothing else to try after IVF. We had tried medication, tried IUI, acupuncture, and other supplements and nothing had worked. There isn't anything more successful than IVF either. We were going from a treatment that is approximately 15% successful to a treatment that is approximately 65% successful. I hoped we would be able to get off this rollercoaster of infertility and begin to heal from all the emotions soon.
I plan to continue our story tomorrow with our IVF process and then my last post on our story what has been going on since then next week. I also eventually want to do a Q & A post on infertility. Many of my friends and family had no idea process of getting pregnant and how many ways it can go wrong, possible diagnoses, different treatments (it's not just IVF), and what happens during it all. If you have any questions about anything related to infertility or what you can do if you know someone going through it, please comment or email me at laura.bambrick [at] gmail [dot] com. I'm happy to answer anything privately, too. Just make sure to tell me in the email.

Goodness!! I'm anxious to hear how IVF is working for you and I hope it is all going well. You've gone through so, so much. I had no idea IUI had so much to it, I thought it was a much simpler process!

Oh how frustrating you didn't have any success with IUI but it's great that you still have another option open to you! :) I know it's very costly though, we know a lady and her partner who are saving up to do it and it's taken them a while. They have no other option though so we will have our fingers crossed it works out for them!